An Episcopal (Anglican) Chaplain in the Saint Luke's Health System of Kansas City, reflecting on work and faith and life. NOTA BENE: my opinions are my own and do not represent the Episcopal Church or the Saint Luke's Health System.

Thursday, August 11, 2011

Healthcare: It's Where the Jobs Are

The article notes, “Healthcare created 31,300 new jobs for the month and 170,900 new jobs in the first seven months of 2011. The healthcare sector has accounted for 18.4% of the 930,000 non-farm payroll additions in the overall economy so far this year, BLS preliminary data show.” The July increase is more than a quarter of all new jobs created in the economy. The latter point is despite the fact that hospitals lost 2,000 jobs in June, and that there were losses in July in long term and other care facilities. It represents more than four times the jobs created in health care in 2010 in the same time period. New jobs were evenly distributed largely between hospital and ambulatory care, with slightly more in ambulatory care.

That’s tremendous job growth, both for one month and for the year to date. Which raises a question for me. In a time when jobs are short, and people everywhere in the economy are looking for signs of growth, healthcare is showing great promise. Moreover, jobs in healthcare are good jobs. They pay well, and have some staying power. They can’t be outsourced overseas (and won’t, I think, be affected all that much by medical tourism), and the market is only growing, both as the population grows and as it ages.

So, why, then, is there so much interest in cutting reimbursement for healthcare? I know that it’s expensive (after all, I’m not just a provider; I’m also a consumer), but I also know that, like other forms of maintenance, preventive care is an investment that will save a lot of money down the line – and preventive care also requires people employed to do the work. I know, too, that healthcare is driven, not by low costs or ego satisfaction, but by individual and immediate need; and so simply insisting on paying less isn’t really going to be an effective means of controlling demand. Indeed, because there are so much to be gained later from preventive care now, I think we need to question whether we want to simply reduce demand by reducing payment, or redirect demand by restructuring payment and actually increasing payment for some things.

One way or another, the numbers (albeit preliminary) indicate that healthcare is a sector of the market that is creating jobs, good jobs, in an economy that needs to put people to work. For all the criticism of the Affordable Care Act, this hardly seems the time to cut the payments, including Medicare and Medicaid, that will undermine that sector and all the jobs it includes now, and can add in the future.